CASE:eNewsletter

January 2006

In this issue

International Adoption: The Sleep Experience
Special Kinds of Adoption: Birth Country Connection
Parent Perspective: Sometimes its NOT about Adoption
Success Stories: Letting Go

International Adoption: The Sleep Experience
By Rachel Plotnick, National Sleep Foundation
Used with permission of the National Sleep Foundation

In June, 2000, Kathy Ramsberger and her husband brought home Amy, a beautiful 13 month-old baby girl from China . Kathy had experienced a difficult pregnancy with her first child and knew that adoption was right for her when she and her husband Brian were ready for more kids.

Amy's arrival changed the Ramsbergers’s life, bringing months of waiting and anxiety to an end, but the road ahead was still filled with challenges – especially when it came to sleep.

In the first few weeks, Amy suffered from many problems common to internationally adopted children. She was ill from a lingering sinus infection that hadn’t been treated with the proper antibiotics. She experienced jet lag and awoke frequently throughout the night. But her adjustment didn’t end there.

For months Amy mourned the loss of her nanny who had cared for her in the orphanage where she was raised in China . She would wake sobbing in the middle of the night and would frequently have nightmares. “She would be saying words that were Chinese or 13 month-old version of Chinese but we could not obviously understand,” says Ramsberger. “We were trying all kinds of things the first few weeks.” Though Amy was able to fall asleep fairly quickly, her sleep was often restless and she needed her comfort object, her blanket, at all times. If Amy was unable to find her blanket, she would wake completely. Because Amy was already 13 months-old, the Ramsbergers wanted her to get used to sleeping alone in her crib. Upon her first awakening they would find her blanket, sing to her, give her a kiss and say goodnight. By the second awakening they were often so bleary-eyed they would lie down in the room with her until she fell asleep.

The Ramsbergers’s experience is a common one. For a child who has never been tucked in at night, read a story or experienced close contact with a caregiver, a “normal” sleep environment may cause panic. And for those children who spent all their time sleeping in an orphanage in the company of other children, the quiet, nicely decorated and uninhibited bedroom their parents have arranged may come as a shock. And those children who were able to form attachments to their caregivers in their country of birth may have sleep problems as a result of their grief related to the loss of their caregiver. “Their whole world is topsy turvy,” says Ellen Singer, LCSW-C, a therapist and adoption specialist at The Center for Adoption Support & Education, Inc. (CASE) in Silver Spring , MD. “Everything looks, feels and smells different. Foods taste different. Everything is different.”

The key to helping an internationally adopted child adjust to a drastically different world, says Ramsberger, is getting information and support. Even before Amy came to America , Kathy wanted to learn about adoption and the challenges she would face as an adoptive parent. She attended a workshop held by CASE to learn how to talk about adoption with her daughter as she got older. Once she brought Amy home, Kathy created a network of people around her and joined a support group. “I think it’s very important that you have somebody you can go to,” Ramsberger said. “I could not have lived without my support group.” Ramsberger was able to talk about Amy’s sleep with other members of the support group she joined, and by sharing common experiences each adoptive parent was able to get answers to questions.

Singer, too, agrees that getting as much information as possible can help smooth an international child’s transition to his or her new life. “What’s critically important is that adoptive parents are working with an agency that can help parents learn about what a child’s adjustment to home may look like,” she says. “Pediatricians familiar with internationally adopted children can also guide parents to have some sense of what the child’s needs are, including special needs. A good agency, plus parents doing their own research, helps them be more prepared.”

Nevertheless, sometimes it is impossible for parents to fill in all their gaps in knowledge about their new child, and they may not be prepared for the adjustments they and their child must make – especially when it comes to sleep. While parents often expect a newborn to have trouble sleeping through the night, they may be surprised when an older child has sleeping issues as well. Internationally adopted children are often 12 months or older – some may even be adolescents. Helping an older child cope with sleeping difficulties can become a daunting challenge for a parent, and understanding the root cause of these problems becomes vitally important. Language barriers are more than just an additional complication.

The life of an internationally adopted child is variable, but in many cases the child must go through an intense period of adjustment. “They’re learning how to be a child who has parents,” says Christine Narad, Clinical Director at the International Adoption Center of Inova Fairfax Hospital and pediatric nurse practitioner. At the same time, parents are learning how to be a parent who has an adopted child. They may have trouble understanding and relating to what their child has experienced, especially if the child has lived through trauma early in life. Trauma can have a variety of effects, according to Singer, including the child’s developmental delays, such as emotional, social, cognitive and physical. It may be difficult for the child to adapt to a drastically different life, and parents may feel unequipped to help their child learn and grow.

Narad frequently counsels parents of internationally adopted children on how to help their children adjust to their new environments and establish healthy sleep routines for life. She recommends:

In the first weeks and months, treat the adopted child, no matter his or her age, like a newborn. Expect that your child needs time to progress developmentally – start at the basics by rocking, cradling and comforting the child as you would a newborn.
Establish very consistent bedtime and wake time schedules. Share quiet, nighttime activities to promote sleep and keep the lights dim at night. In the morning, make the room sunny, say “good morning” and prepare your child for breakfast and play time. The right amount of light and dark will be especially important as you help the child recover from jet lag.
Create a consistent routine by doing activities in the same order every morning and every night. For example, teach your child that each night you will have dinner, followed by a bath, followed by bedtime. This consistency will help reassure your child that he/she is in a safe environment with predictability.
Pay attention to your child’s environment and any factors that might prevent him/her from sleeping. For example, you might not even notice the sound of a ticking clock in the room, but for a child who is not acclimated to the environment, the sound could be frightening and unexpected. Try white noise (such as a fan) or soft, classical music to block out unwanted sounds such as a garbage truck or dog barking.
Consider what effect the decoration of your child’s room might have upon him or her. A room that has bright walls or a busy theme may be disturbing to the child. Expect that he or she has been exposed to environments that don’t have as much color, stimulation or noise.
Be available for the child when he or she is crying at night. If the child starts to whimper, talk to him or her. You may need to rub the child’s back, encourage the child to suck his or her thumb or to cuddle with a toy or blanket. If the child is absolutely beside herself then pick her up and comfort her.
Practice good sleep hygiene with your child, as soon as possible. Start to give him or her tools to self-soothe by giving the child a comfort object and by feeding him/her enough before bedtime so he/she doesn’t expect a bottle in the middle of the night (many orphanages feed young children in the middle of the night).
Monitor how the child responds to different activities and the amount of activities. Avoid over-stimulating activities during the day; they may affect the child's ability to sleep that night. Try not to introduce too many new people or activities in a short amount of time.
Make choices that are healthy both for you and your family. Some parents choose to co-sleep with their newly adopted child, while others want the child to have his or her own crib in the parent’s bedroom, and others still want the child to have his or her own crib and room. Balance your child’s needs with what feels comfortable for you.
Learn about the common phases of sleep an internationally adopt child may go through. For example, at the three-month mark 85% of internationally adopted children will begin waking every hour throughout the night. This is a testing period for them – they want to know whether they can trust you and whether you will come when they need you.
Remember that as a parent, you’re not going to sleep initially. You are going to be tired and this is an ongoing process. Children’s anxieties come out during sleep. There are going to be a lot of tired people in the house, but be patient and know that your child will adjust as time goes by.
Recognize that the adjustment period takes time. It takes about one year for most children to become acclimated to their surroundings and adjusted to their sleep routine and lifestyle.

Bringing a new child into your home, whether biological or adopted, takes a lot of patience, time and learning for the whole family. Just as adoptive parents must have patience with their child’s development and adjustment, it’s also important to be patient with themselves as parents. “Don’t be too hard on yourself,” Ramsberger says. “You read these books about sleep disorders, sleep issues…and the techniques work, but we’re human. If you can’t let your child cry it out it’s ok. Keep trying, don’t give up.”

Singer adds, “Sleep is perhaps the one activity in the course of a day when all of the international adoption experiences come out – the vast changes/losses that confront the child and the accompanying grief, the insecurity he or she is undoubtedly experiencing, the language barrier, and the parents’ own uncertainty. Not all the recommendations for children that have been with parents from birth may apply and parents should feel free to consult with other adoptive families and professionals with a lot of international experience to develop their own ideas of what establishes trust, comfort and a viable sleep experience. Making the sleep experience a priority can pay off for the child and the whole family.”

Looking back on her experience, Ramsberger is extremely positive about her decision to adopt, and she urges parents to have faith, even when they’ve experienced the life crisis of infertility and long to be parents. “You’ve got this great hope and this great anxiety, and you carry it until you get that baby or child in your arms,” she says. “My biggest advice is to know that it’s going to happen. It’s such a wonderful way of making a family, of adding to your family.”

GET SUPPORT AND INFORMATION ABOUT INTERNATIONAL ADOPTION

Resources:

Center for Adoption Support & Education, Inc. www.adoptionsupport.org
National Adoption Information Clearinghouse naic.acf.hhs.gov/
Parents Network for the Post-Institutionalized Child www.pnpic.org/
RESOLVE of the Metropolitan Washington Area www.resolvedc.org

Books:

Parenting the Hurt Child: Helping Adoptive Families Heal and Grow by Gregory Keck
Toddler Adoption: The Weaver’s Craft by Mary Hopkins-Best
Real Parents Real Children by Holly Van Gulden
Beneath the Mask: Understanding Adopted Teens by Debbie Riley and John M.D. Meeks
Attaching in Adoption by Deborah Gray
Sleeping Through the Night: How Infants, Toddlers, and Their Parents Can Get a Good Night's Sleep by Jodi Mindell
Take Charge of Your Child's Sleep: The All-in-One Resource for Solving Sleep Problems in Kids and Teens by Judy Owens and Jodi Mindell

For further information: www.sleepfoundation.org

Special Kinds of Adoption: Birth Country Connections
For Families with International Adoption

There are many, many times when parenting adopted children is just ordinary, challenging, rewarding mothering or fathering . However, there are several aspects of adoptive parenting that are different, and one is the normal and necessary task of helping children make connections to their heritage .

Heritage is the legacy given to us through our biological roots . Adopted children—unless adopted by relatives—do not share genes and ancestors with their parents . They have their own unique heritage . Many children, especially those who have been adopted internationally, bring the additional gift of a different ethnic heritage, making their families multicultural . It is one of the great joys of international adoption, and one that can be celebrated proudly .

Parents look for ways to put their children in touch with their birth culture and country . They may buy books, attend festivals, search out music, art, cuisine, and friendships which can help incorporate their children’s ethnic heritage into the mix of heritages that already exist in the extended family .

As much as parent enjoy these connections, it is important to remember that they are essential for the children’s well-being . A strong sense of cultural identification and pride contributes to healthy self-esteem and adjustment . The foundations for this are set in early childhood, but are often relied on heavily in adolescence to boost youngsters into early adulthood with a sense of satisfaction about who they are, where they came from, and ultimately, where they are going .

The Birth Family and the Birth Country

Most parents who adopted internationally have no connections to their children’s birth families, although openness is certainly in the wind throughout the U . S . and it seems to be spreading to some countries abroad as well . In the absence of comprehensive information about birth families, most substitute their children’s birth country as the source of information about their heritage . This can be a positive, rewarding connection, but it can skew the emotional ties that their children feel toward the land and its people .

Parents should be aware that the birth country, serving as the birth mother in abstentia, may create a wide range of emotions, including pride, anger, love, hate, fantasy, and fear . Parents need to consider this when they measure their children’s expressed interest in learning about their birth country and when they try to determine what connections are best at what time.

Because of the birth country’s double layer of importance, parents also need to be particularly aware of how their children are learning and feeling about it . Children may be discussing the country in social studies or history, or current events may create a focus on one aspect of the country . Some people may express generalizations that are highly inaccurate or hurtful . Just as children’s concept of themselves as adoptees is greatly influenced by how adoption is viewed by those around them, their perception of their birth country, and consequently their birth family, can be impacted by the opinions and statements of others.

These complexities challenge parents to plan for long-term efforts to help their children learn about their birth countries . As children grow up, they can be helped to recognize that ALL countries have positive and negative aspects . They can learn how history, culture, language, and conflict have shaped the customs and beliefs held by the people in their country . Children will develop a greater regard for their birth country if they are helped to know it in depth, similar to the kind of knowledge they will gain about the U . S . by living here . They will be better equipped to understand their individual adoption stories, their identity, and their heritage if they can put these in the context of the culture of their birth country.

To help children gain this level of understanding, many parents consider returning to the children’s birth countries for a visit . What is right for THEIR family and THEIR child may not be right for the next family . There is no one size fits all, as children bring their own unique adoption story, memories, emotional resources, personality, and needs to each situation . The Center for Adoption Support & Education, Inc . has created the following questionnaire to help parents look at some of their many choices for connecting to the birth country, while considering what is best for each of their children and what is comfortable for their family .

Parent Questionnaire – click to download

Many parents find that their decisions about what is right for their family can be helped by talking with other families who have adopted internationally . These connections may be made through the placing agency or through the strong national and local family groups such as Families with Russian and Ukrainian Adoption (FRUA), Families with Children from China (FCC), Latin American Parents Association (LAPA), or Korean Focus for Adoptive Families . Organizations arranging homeland tours will also assist by answering very specific questions regarding anticipated experiences, and they will also connect parents to those who have traveled earlier .

Lists of all of these organizations are available through the National Adoption Information Clearinghouse (NAIC) at naic.acf.hhs.gov/

or 888-251-0075 .

Parent Perspectives
by Ellen Singer, LCSW-C

Question: Sometimes it seems that when my 10 year old son, adopted from Guatemala as a toddler, experiences some kind of slight or rejection, he automatically thinks that what happened is somehow related to being adopted. “They don’t like me because I am different.” It seems to me that he is taking something personally that is not about him (the other person just isn’t a very warm, friendly person) or it has to do with a personality trait of his. (He can be shy and people might not know quite how to engage him.). How can I help him to understand this without discounting his feelings related to adoption?

At C.A.S.E. , we put a great deal of emphasis on educating adoptive parents about how children feel about adoption . Our goal is to enable parents to help their children to identify, understand, and express their feelings about adoption . That awareness can help parents be alert to times when adoption is on our children’s minds or impacting their lives .

Part of this task involves helping children understand their feelings about being adopted in the context of typical (and atypical) growing-up experiences . This is no easy task, especially if we think that our children mistakenly “blame” adoption for something that happens . All parents have to find ways to help our children understand the emotions and motivations of other people . This can be especially challenging for parents whose adopted children may be understandably and normally more sensitive and vulnerable to feelings of rejection, or if they are going through a phase when they feel they don’t fit in (something that is common in adolescence) .

Some examples: Carol, a mother I spoke with recently shared this experience . Despite her efforts to promote the relationship between her daughter, Cindy (adopted domestically at birth), and her sister’s family, the latter have remained only superficially interested in her daughter . As a preteen, comparing these relationships to those of her best friend, Cindy has expressed sadness over this realization . She wonders if the difference in her relationships is because these relatives do not really consider her to be a legitimate part of the family . Carol suspects that this is not the reason for the failure of her family to connect with her daughter . Instead, she believes it has more to do with their busy lives, and their general lack of interest in other people’s children, including the children of their closest friends . Carol continues to acknowledge her daughter’s disappointment while encouraging her to be herself as she relates to these relatives, and to try to remember to take their response as a statement about them and not about her . More importantly, Carol used this opportunity to help Cindy express feelings related to belonging, her birth family, and providing her with reassurance, reminding her of the strong relationships she enjoys with other extended kin .

Another mother, Lori, has an eight year old son, Tim, adopted from Korea at the age of two . Tim is able to make friends, but sometimes loses these friendships as quickly as he makes them . Lori perceives the problem to be that Tim can be a bit bossy and aggressive at times . However, Tim has stated that he feels the kids don’t like him because he’s adopted . This is because some his classmates have asked him questions about being adopted, “Why don’t you look like your mother?” and “Why didn’t your real parents keep you?” Lori has acknowledged the impact of Tim’s peers’ attempts to understand adoption but she has also tried to refocus Tim to examine the aspects of his personality that might be interfering in his relationships with peers… and not blame adoption to avoid this self-examination .

Parents who are trying to understand their children’s behavior are welcome to contact C.A.S.E. to explore concerns!

Letting Go
By Memi Miscally
Ms.Miscally, an adult adoptee from Korea, shares her journey to her birth country

Although I planned carefully for my journey to South Korea , I encountered a few surprises while there . I did not expect to find my birth family, but I thought I might learn something new while reviewing my adoption records in Seoul . I was stunned and angered when I heard that my adoption information may be false . Although I had heard others recount this setback, I had never thought it would happen to me .

In a sense, the trip drew me farther away from my birth family than ever before . Yet I also formed important connections while in South Korea .

I met my foster mother . Before then, I knew that she had cared for me during the first four months of my life, but I did not realize that she loved me until she hugged me and recounted how she cried on the day I went to my adoptive family .

I also became friends with other Korean American adoptees . I thought that being older would isolate me from them; however, I found an immediate bond . With them, I talk freely about my experiences . We do not hesitate to discuss issues such as “loss” or “racism . ”

During my journey, I stumbled upon the unexpected and made it part of my life . I am therefore no longer as afraid of what I cannot predict . It has been helpful for me to realize that I cannot control every aspect of my life, and thus accept the idea of letting go.